Children's hospitals prescribe antibiotics inappropriately for 25% of patients, study shows

A quarter of the kids receiving antibiotics at U.S. children's hospitals are given antibiotics that are unnecessary or not appropriate for their care, a study published in Clinical Infectious Diseases shows.

Researchers analyzed medical records of 11,784 children, younger than 17 years, who had been prescribed one or more antibiotics in 32 U.S. children's hospitals. The data was collected from July 2016 through December 2017. In all, providers prescribed antibiotics 17,110 times.

Around 25 percent of the patients received at least one antibiotic deemed "suboptimal," which means clinicians "shouldn't have prescribed any antibiotics; they could have used a more effective antibiotic; or they could have prescribed a different dose or for a shorter duration," said Jason Newland, MD, director of the antimicrobial stewardship program at St. Louis Children's Hospital and one of the study's lead authors.

The most common examples of inappropriate antibiotic use were:

• Wrong antibiotic given for a particular infection: 27 percent of cases where children received a suboptimal antibiotic
• Prolonged antibiotic use after surgery to prevent surgical site infections: 17 percent
• Unnecessary antibiotics given: 11 percent
• Broad-spectrum antibiotic used instead of a drug that targets the specific type of bacteria: 11 percent

The study also found in half of the cases where children received suboptimal antibiotics, the prescriptions were not reviewed by the physicians and pharmacists involved in the antimicrobial stewardship program, as the program only recommended examining the use of specific drugs.

 

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